1. Field of the Invention
The present invention relates to medical devices, and particularly to an image-based feedback endoscopy system for imaging the interior of an organ of the body.
2. Description of the Related Art
Due to the relatively high recurrence rate of bladder cancer, frequent cystoscopic surveillance can be required for patients following initial diagnosis. During examination, the urologist manipulates a cystoscope to thoroughly inspect the bladder wall. These procedures can constitute a significant percentage of the urologists' workload, making bladder cancer a relatively expensive cancer to treat over the patient's lifetime.
Many minimally invasive procedures can require a clinician to manually articulate an endoscope, often in conjunction with multiple surgical tools. Manual articulation can be burdensome because endoscopes must be held steady. Further, manipulation of the hand controls may produce motion of the endoscope's tip that is non-intuitive with respect to the displayed images. These challenges may be detrimental to surrounding tissue and may increase procedure times, thereby possibly imposing considerable financial costs. Computer-controlled articulation of endoscopes could provide clinicians with greater control during diagnostic and therapeutic procedures. Previous attempts have employed image-based steering to articulate an endoscope in cardiac surgery, by directing the endoscope's tip to a position selected on the monitor. These previous attempts of image-based steering generally circumvented the difficulty of manual endoscope articulation.
Robotic assistance has also been used to avoid endoscope's tip collisions with delicate anatomical structures. Previous attempts have employed collision avoidance in arthroscopic and spinal cord procedures. For example, a robotically articulated ultrasound probe was used to enable intraoperative image-based navigation during prostatectomy. Furthermore, robotic assistance has been used to stabilize the focus of endoscopic images. For example, one approach demonstrated a system that keeps the center of a lumen at the center of the monitor's image during gastroscopic procedures. In another approach, an endoscope maintained focus on an anatomical feature in spite of periodic respiratory disturbances.
Robotically assisted surgical instruments have become commercially available within the last 20 years. Examples of these instruments include the da Vinci system (Intuitive Surgical, Sunnyvale, Calif.), which has improved clinician dexterity in many FDA-approved procedures. Another example is the FDA-approved ROBODOC assists surgeons in hip and knee arthroplasty procedures (CUREXO Technology Corporation, Freemont, Calif.
A newer approach to diagnostic procedures involves fully automating surveillance in order to eliminate the need for direct clinician oversight. Procedures not requiring clinician oversight could be advantageous because they may be administered by PAs, which further reduces cost and increases patient access to care. An example of such a procedure is wireless capsule endoscopy (WCE). During WCE, a pill camera captures images of a patient's digestive tract after being swallowed. Since WCE does not require the clinician to directly oversee the procedure, a PA may administer WCE and gathered data can be digitally transmitted for expert analysis. Allowing PAs to administer surveillance may also reduce the workload of busy clinicians.
Flexible endoscopes have a forward-view (or limited a few angles available) with a limited field-of-view age size. The performance and sensitivity of the manually-operated endoscopy surveillance depends on the care, memory, ability and experience of the operating clinician, since it only allows an operator to see a quite small portion of the surface of the organ. These challenges may increase procedure times, there by imposing considerable financial costs, and decrease sensitivity of the procedure.
Thus, an image-based feedback endoscopy system solving the aforementioned problems is desired.